In healthy cells, mitochondria continually divide and fuse to form a dynamic interconnecting network. The molecular machinery that mediates this organelle fission and fusion is necessary to maintain mitochondrial integrity, perhaps by facilitating DNA or protein quality control. This network disintegrates during apoptosis at the time of cytochrome c release and prior to caspase activation, yielding more numerous and smaller mitochondria. Recent work shows that proteins involved in mitochondrial fission and fusion also actively participate in apoptosis induction. This review will cover the recent advances and presents competing models on how the mitochondrial fission and fusion machinery may intersect apoptosis pathways.Apoptosis mediates the catabolism of eukaryotic cells that is crucial for metazoan development, adult tissue turnover, host defense pathways, and protection from cancer. All pathways of apoptosis converge upon the activation of caspases, proteases that orchestrate the efficient and noninflammatory demolition of cells. Two main pathways leading to caspase activation have been well characterized: the extrinsic route initiated by cell surface receptors leading directly to caspase 8 activation, and the intrinsic path that is regulated by mitochondria. The mitochondrial stage of apoptosis control is upstream of caspase activation and is mediated by the Bcl-2 family of proteins. One well understood role of mitochondria in caspase activation is to regulate the release of proteins from the space between the inner and outer mitochondrial membranes to the cytosol. When cytochrome c is released from mitochondria, it binds to APAF1 in the cytosol, activating the assembly of the apoptosome that activates caspase 9 (Bao and Shi 2007). Other proteins released from mitochondria, such as SMAC/Diablo, have less crucial accessory roles in caspase activation, perhaps most important in long-lived cells (Potts et al. 2005).Bcl-2 family proteins regulate the release of cytochrome c and other proteins through the outer mitochondrial membrane (OMM) (Adams and Cory 2007;Chipuk and Green 2008). Some members of the Bcl-2 family inhibit apoptosis, such as Bcl-2, Bcl-xL, and Mcl-1, whereas others, such as Bax and Bak, activate apoptosis. Bax and Bak actively induce cytochrome c release from mitochondria within cells and in cell-free systems, both of which are inhibited by anti-apoptotic Bcl-2 family members. As the anti-apoptotic Bcl-2 family members closely resemble the proapoptotic members in structure, they may function as dominant negative inhibitors by binding and inhibiting Bax and Bak. Another class of disparate proteins including Puma and Bim, called BH3-only proteins, shares a short motif with Bcl-2 family proteins and regulates their activity. One model posits that upon apoptosis initiation, BH3-only proteins are induced and then bind and inhibit anti-apoptotic Bcl-2 family proteins, allowing pro-apoptotic Bax and Bak to permeabilize the mitochondrial outer membrane releasing cytochrome c and other proteins to activa...